The AJCC 8th edition staging threw everyone for loop--perhaps none more than the breast and head and neck (H&N) sites. But what about the most common malignancy of all? Cutaneous squamous cell carcinoma (cSCC) has been thrown in with H&N staging as an after thought for years. A new analysis in the Annals of Surgical Oncology demonstrates the woes of dragging it along for another 8th edition ride: incorporation of extracapsular extension in the new staging upstaged an unbelievable three-quarters of the almost 400 evaluated patients with node-positive cSCC, making over half of these (skin cancers!) stage IV. To no surprise, the 8th edition staging very poorly predicted for overall survival. TBL: cSCC needs its own staging.


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